


Family Medicine

by J_Baillier



Series: You Go To My Head [15]
Category: Sherlock (TV), Sherlock Holmes & Related Fandoms
Genre: Angst, Autism Spectrum, Doctors Holmes and Watson are back, Don't copy to another site, Family Drama, Hiding Medical Issues, Hurt/Comfort, M/M, Medical Conditions, Protective Parents, Urology, anaesthesiology, neurosurgery
Language: English
Status: Completed
Published: 2019-03-31
Updated: 2019-04-08
Packaged: 2019-12-30 01:20:42
Rating: Mature
Warnings: No Archive Warnings Apply
Chapters: 3
Words: 14,259
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/18305264
Author URL: https://archiveofourown.org/users/J_Baillier/pseuds/J_Baillier
Summary: As though a disastrous Christmas in Sussex hadn't already strained Sherlock's relationship with his parents to a breaking point, Violet and George Holmes now have devastating news to deliver. Will it bring Sherlock closer to his family or drive the wedge between them even deeper?





	1. No news is bad news

**Author's Note:**

> Betaed by 7PercentSolution and ASilverGirl. As always, you were brilliant.

It's six in the evening; John has stayed past office hours at work to wait for Sherlock so that they could head to Belgravia together for their eight o'clock restaurant reservation. Parking in that area is a nightmare, so they've taken a cab to work today—John wouldn't have wanted to drive, anyway, since he would have had to forego the delights of Pétrus' award-winning wine list.

It's quiet in the small admin section of the Bessemer wing; only he, Greg Lestrade and two other senior surgeons have their offices there along with their secretaries. Lost in thought over how precisely he should phrase a strongly worded email to a supplier, John is startled when his office landline rings. _Who would be calling him at this hour?_

"Evening, Doctor Watson; it's Mark from reception. I've got a pair here who says they're family and that they'd like to visit. The name's Holmes."

Now, John is less surprised but a bit confused. Weren't Violet and George supposed to meet them at the restaurant? "Send them up."

"I can't open the fourth floor foyer doors from here."

"I'll meet them by the lifts."

He goes to wait at the end of the corridor. Soon, the lift doors open, and Violet and George Holmes, glancing around their unfamiliar surroundings, step out. John unlocks the glass door and lets them onto the admin floor.

Violet, dressed in a perfectly fitting mint green houndstooth blazer suit and matching kitten heels, gives John a reserved hug and a peck on the cheek, which he reciprocates. George shakes his hand vigorously, removing his flat cap. He is wearing a nice suit to complement his wife's ensemble, but when it comes to picking coats and caps even for a city jaunt, he never looks like the scientist-turned businessman he was before retirement, instead favouring country gear. He is a biochemist who had made a fortune from developing a bacteria-based sanitary water purification system. Then again, Violet hardly looks like the economist genius she is lauded as being; her style is more that of a Belgravia socialite. John has always liked them in that they are not pretentious, nor do they flaunt the considerable amounts of money they possess. As for their other traits, some things have come to light within the last few months which have partly soured John's attitude towards his mother-in-law in particular.

"How are you, John?" George asks.

"Fine, absolutely fine. Come, have a seat. I'm afraid I haven't got much to offer; if we want tea we'd have to head back down."

"Oh no, dear, we've just had some," Violet replies.

John takes them to his office and rearranges the chairs so that they can all be seated by his desk. "I thought we were meeting up at Kinnerton Street. Did you want to speak to Sherlock? He's still in surgery."

"He works so hard, doesn't he?" Violet smiles keenly. "You both do, of course."

"Well, anaesthetists might have it a bit easier since we don't have to be on our feet for the whole operation."

"He did mention that his case was likely going to stretch past office hours, which is why we took such a late reservation," Violet explains in her usual, fussy manner.

"Have you been to Pétrus before, John?" George asks. His gaze seems to be sweeping the contents of the wall shelves, most of which are filled with old textbooks and papers left over from John's predecessors. He means to eventually get around to clearing them out.

"Once, but that was years ago. Mycroft's favourite, I think?"

"Pity he couldn't join us," Violet muses.

John stifles a chuckle. Sherlock's older brother is in New York, receiving an award at an international business forum. When John has asked what it was for, Sherlock had replied 'bloated portentous capitalist of the year'.

George remains quiet but then again, Violet has always been the quicksilver one; she possesses the same nervous energy Sherlock has inherited. But, Sherlock doesn't have the woman's natural, gregarious, chatty conversation skills; he takes more after his father’s more succinct and analytical approach. To John, his husband seems to be a reflection of some of the best—and worst—qualities of both of his parents, although he’s not been brave enough to say so out loud. The Holmes parents, especially when it comes to similarities between their younger son and them, have always seemed to be something of a sensitive spot for Sherlock, even before the falling-out last Christmas. That disastrous stay in Sussex had deepened the divideto the point where it is surprising that Sherlock had agreed to meet his parents for a birthday dinner. John wonders if this impromptu meeting is somehow related to that. _Is Violet after some advice before their reunion?_

"So, what can I do for you? I assume you didn't come all the way across town just to see me?" John suggests with a courteous chuckle.

"It is always nice to see you, John, and we so enjoy having you for Christmas. I bake too much, I do, we need more people at the table and it's the only time we get to see Sherlock for any length of time. I'm just sorry that this year it ended on such a bad note. Not your fault, of course, not in any way."

George nods. "The two of you should come visit soon again." He sounds a bit distracted.

John isn't convinced this isn't really what they had come to discuss, especially since last Christmas had gone the way it had. After several sessions with Joanna Pichler, Sherlock seems to have found his calm and motivation again after being well and truly beside himself for some time, but that only applies to work and their home life.

He knows Sherlock hasn't seen or spoken to Violet after they'd left Sussex so abruptly on Boxing Day.  

Violet glances a bit nervously at his husband, who places his palms on his knees as though seeking a source of fortitude there. "Go on, then," she says, nudging him with her elbow.

He looks reticent, then clears his throat. "John, I have some news."

John frowns. "I really think Sherlock should be here for this. I don't know how long he'll be; I could call the OR floor Ward Sister––"

"He still hasn't called me back, you see," Violet says quietly.

"He agreed to this dinner," John points out. "I'm sure it'll be fine."

In reality, John is not sure at all how tonight will go, and sincerely hopes that whatever has been discussed between psychiatrist and patient, it will help Sherlock not get provoked into another open altercation with his mum. "I really think Sherlock should be present if you have something important to discuss."

John remembers a brief conversation from Christmastime: George was asking her if Sherlock knew about something, and Violet promptly shut down that line of inquiry. _'Not here, not now_ ', she had said. John had been more concerned with Sherlock than whatever the topic of that cryptic exchange had been, so he forgot about it—until now.

Violet raises her hand in dismissal. "No, no, we don't want him to worry, you see, not in the mood he's been in. Not until we know more."

"About what?" John leans forward in his seat.

"The thing is––" George starts, "They found something in the blood tests just before Christmas, and took a biopsy two weeks ago."

"You went to see a doctor after I told you to get yourself sorted for keeping the whole house awake with your hourly trips to the loo," Violet explains a nervously. "He—I mean Doctor Rose, he's our GP, he's very good—called us about the result the next day. He sent George in for some bloods before he could prescribe something but then that prostate value was rather elevated and there was another and they calculate their ratios."

"PSA value?" John suggests.

"That's the one," George confirms. "So, now the biopsy results have come back, and they say it's cancer, but they can't decide how aggressive. So, they aren't really saying this or that whether it should be operated on or just monitored; the urologist said that some cases never grow so fast that they need to be removed. She thinks magnetic imaging should be done because they couldn't decide."

"Who _wouldn't_ want the surgery? Who could possibly have cancer and not want it taken out? It's preposterous!" Violet complains.

George gives her a sideways glance. "They seem to want to leave the decision with us. They say that it might be so slow to grow that it might not ever get to an incurable state, but at my age and condition I might have so many years left that it could… develop. So they say they could operate, if I preferred that and the magnetic slides pointed to something or other. But there are risks, of course."

"Of course," John nods. He feels alarmed and confused; he doesn't think it's fair that they are telling him first and not their son.

"It's just so overwhelming, all of it," Violet complains, throwing up her hands. "All this information online about hormones and new treatments and surgical techniques and some people are even saying they shouldn't even screen for it, that it would be better than they didn't find all these cases that might be if not benign, then at least so very slow to develop."

"Does Mycroft know? Have you discussed all of this with him?"

"He knows what's happened, yes, but he's not a doctor, is he? He knows a lot but it's not the same," Violet dismisses.

"Well, I'm not a urologist," John says, one brow hitching up.

"Of course not," Violet fusses, "But you must know some good ones? Your previous landlord, for instance?"

"He's long retired, so he might not be your best bet of getting a very up-to-date opinion. We do have an excellent urology unit here at King's; I'm sure they'd accept a referral from Doctor––?"

"Carole Michael's the urologist I've seen," George replies. He looks relieved. "That's what we wanted to talk to you about, getting some names we could give to him."

John has a think on this before replying: "Henry Holcombe is the head of the urological cancer unit, and he sits on the board which formulates the national treatment guidelines. He's got to be on top of all the recent research."

"Thank you, John," George says, sounding relieved. "That's all we wanted, really, to have a name for getting an expert opinion."

"Sure. But, shouldn't we tell Sherlock?"

"At his birthday dinner?" Violet looks horrified. "No, John, absolutely not. He's not good with worrying about things, doesn't have the emotional resilience that our Mycroft does. George and I have discussed this, and we think it’s best that Sherlock not know until there is a definite plan, especially if that involves surgery." 

George nods. "He obviously has a very taxing operation today and it's his _birthday_ , after all. I don’t want to be talking about this over what should be a celebratory meal. Would you let us cover the bill tonight? I'm afraid all this dreadful business has taken up so much time and energy that we've not had time to think of a gift for him."

"You could pitch in to mine: my second cousin has bought and restored a hilariously small castle near Inverness into a boutique hotel; I'm taking Sherlock there at Easter," John explains.

"That's a good idea. Of course we'd be happy to participate," George replies distractedly; he is jotting down _'Henry Holcombe_ ' into a pad he has dug out from his jacket pocket. Like his older son, he favours Fielding & Nicholson suits. Sherlock tends to go in for the prestigious Chittleborough & Morgan, while John is happy with off-the-rack Hugo Boss.

"Oh, and I believe we're dining on Mycroft's tab tonight since he couldn't make it," John says. He tries to make his tone light, but he's troubled by the thought of concealing such important news from his spouse. "You will tell Sherlock as soon as you can, won't you?"

"Yes, of course, when the time is right, once we know more and have made some decisions," Violet fusses, repositioning her handbag on her lap.

"He may well guess something's going on tonight," John says. "He's frighteningly observant."

Violet rises to her feet. "Come on, George; if we get a cab right away and the driver manages to circumvent roadworks, we might make it to Philip Treacy's sale before they close. There's two weddings this summer I must prepare for."

John gives George a collegial I-know-how-you-feel look; when Sherlock is in shopping mode he'll take hours and hours fine-tuning every detail of his sartorial purchases, leaving John to yawn in various Savile Row shop armchairs.

"See you at eight," George says politely, and follows his wife out of John's office.  
  


-o-0-o-0-o-0-o-0-o-0-o-

  
Just as John begins to worry whether they'll make it to their reservation, Sherlock texts him from the basement level locker room. Five minutes later, they meet up at the taxi stand in front of King's College Hospital's Normandy building.

Sherlock looks a bit flustered as though he'd rushed out of the OR, and his curls are a bit flat after being confined in a cap all day. John reaches out to do one of his favourite things: ruffle them a bit.

Sherlock follows suit, shaking his separated fingers through both sides of his head. "I must look a fright. There's something wrong with the thermostat on the OR floor again, we were positively boiling for half of the case."

"How'd it go?" John knows he'd done a removal of a double arteriovenous malformation located at the bottom of a patient's cerebellum.

"The vasculature inside the AVM was really brittle; it was a good idea to have some of the feeder vessels embolised beforehand." Sherlock's tone signals that he doesn't want to consider how challenging the operation would have been without such a precaution. "But, it went alright. Good, actually."

John gives him an encouraging smile. He feels put on the spot, under scrutiny, even though Sherlock has no reason to believe that there's anything amiss. John hates keeping secrets; they had promised one another they'd never do that again. He feels terribly conflicted; the Holmeses had come to him in medical confidence, which he shouldn't betray. It's the only legitimate reason he can come up with for telling Sherlock immediately what he has learned.

He slips his hand between Sherlock's arm and his side and laces their fingers as they take up a position at the edge of the kerb. "Happy birthday, love. Champagne tonight, yeah?"

Sherlock is craning his neck, trying to spot a cab, but he's heard the words and slips on a tight smile, eyes scanning the traffic. To John he looks quite tired; it's not the operating itself that exhausts him the most but having to interact with other staff for such a long time without getting any breaks. Of course, there would be silence in the OR during critical stages, or Sherlock's music playing from the speakers, but even the presence of others can be a heavy distraction for him. He had once told Anderson to stop _thinking so loud_ when they had operated together. ' _You lower the IQ of the whole surgical floor_ ,' he had told his fellow neurosurgeon who had thankfully only rolled his eyes—Anderson was already very familiar with Sherlock's knee-jerk rudeness when under pressure.

Finally, a cab answers their summons. Getting just to sit in the back, watch the scenery and rub his thumb across Sherlock's knuckles is heaven for John. The courage for these open public displays of affection had not come easily to him, but now he finds nothing more natural than to seek such a connection after they have both been wrung dry by a workday.

 

-o-0-o-0-o-0-o-0-o-0-o-  
  


They arrive at the restaurant five minutes before eight. Violet and George are waiting outside the entrance, and she wastes no time in going for a bone-crushing hug of her son.

As usual, Sherlock doesn't completely manage to conceal his annoyance over what he considers an unnecessary and annoying social convention such as celebrating his birthday. He does enjoy a well picked-out gift but all the associated fuss and socialisation collides with discomfiture about dealing with other people's behavioural expectations. He’s avoided anything remotely like a birthday party for years, and only reluctantly agreed to this annual event of a birthday dinner in the years when he and John have chosen to spend Christmas together overseas. His decision to accept the invitation this year is the clearest signal that John can see that he's willing to at least try to put the disastrous Christmas holiday behind him.  

The restaurant has soft, ambient lighting: warm yellow LED strings have been hidden in the circular indents in the ceiling. John knows this will help make Sherlock more comfortable but he's also certain that the Holmes parents probably haven't have based their restaurant pick on such a detail. As is demanded of a Michelin star establishment, the linens are crisp and blindingly white, the cutlery arranged perfectly symmetrically, and the service as they are taken to their table is attentive but discreet. Soft fabrics afford acoustic privacy and the soft, white chairs are comfortable instead of being some hard-surfaced modern monstrosity. The restaurant is only two-thirds full, so the noise of conversation isn't distracting.

George suggests the Discovery Menu, but Sherlock shoots down the idea; John knows he wants to control the number of dishes and their content, lest he is presented with something he finds off-putting. The current Discovery features mackerel and calamari, both of which John knows to be definitely on Sherlock's hit list of culinary enemies. Unsurprisingly, he grumbles a bit about Dorset crab being ruined with grapefruit in one of the starters on offer.

John goes for an aged steak tartare as his starter; Sherlock selects a parsley and garlic risotto. As a main, they both go for Roast Cornish turbot.

Soon, the whole table is toasting with Bollinger La Grande Année, glasses swiftly condensing from the perfectly cooled champagne. By the time they have each downed half a glass, Sherlock is blinking and his cheeks a bit rosy; John realises that, thanks to his marathon surgery, his husband may have not eaten anything since… breakfast? The champagne must be going straight into his head since he never tends to consume more than one portion of alcohol, claiming it slows his thinking down and makes him feel uncomfortable.

John wonders if it might be a good thing for Sherlock to get a bit tipsy; perhaps it'll prevent him from noticing there's anything fishy going on anywhere else than on his plate. John already hates the fact that he may have to explain and apologise for not coming clean, but this is not his private matter to reveal. He gives George a pointed glance, but the man doesn't appear to make much of it.

Violet is chattering away about this and that. "––did we go to Bollinger the last time we were in Champagne, George dear?"

John explains about his birthday present, and Sherlock positively beams. Relief washes over John; he had been mildly worried that Sherlock might not be keen on a rural setting for their next holiday. He seems to prefer city breaks, even if they tire him out with the overwhelming combination of people and traffic. There was Malosa, of course, but that was different since half of the point of that trip was work.

Over their starters, Sherlock points his fork at his father. "Why are you being so quiet?"

John perks up. _Uh oh._

"Oh," Violet dismissed with a flick of the wrist that is exactly identical to Sherlock's swishy gestures when he tries to reroute attention away from himself, "I've dragged him around half the shops in Knightsbridge today; he's just a bit knackered."

"Yes, dear," George concedes.

Sherlock pushes the remaining half of his risotto around the plate, giving his table companions occasional glances. He appears thoughtful.

John keeps his eyes fixed on his own food.

"I know you can't talk about details due to medical confidence rules, but how was your case today?" George asks, and to John it seems that he's trying hard to sound cheery. Even a stoic, calm man such as the head of the Holmes family must be reeling and distracted by the news he's had, with so many unknowns. Some patients live for decades less aggressive prostate cancer variants—and some manage years with types that have metastasized. John's opinion is that patients and their loved ones shouldn't be the ones tasked with finding answers; it should be their GP and their urologist. It's a positive surprise that the Holmeses haven't run straight to the private sector when they began feeling apprehensive about the recommendations—or lack thereof—they have received.

The explanation to that comes after Sherlock has given a short explanation of his operation: "So, what is this robotic surgery we keep hearing about?" George asks. "Do you do it?"

As far as John knows, the only urology units in London making use of robotic equipment are some of the university hospitals. The private sector has seemed hesitant to go for such expensive acquisitions until more research data on their benefits comes in.

"No. We are so far only using it for certain types of cancer surgery. Urologists have a routine with it, gastric surgeons are getting keen but King's gynae are still hesitating, I hear," Sherlock explains.

George dabs sauce off his lips. "So, what are the benefits?"

"No tremor from the surgeon's hands, no effect of fatigue on dexterity. Good access to the pelvic bottom and the back parts of the abdominal cavity which would otherwise require wide incisions and lots of rummaging around. Not much potential for neurosurgery there so far; it's meatball surgery that suits such an industrial approach."

John spots Violet looking a bit green around the gills. "Did your new roses survive the winter, do you think?"

"I think so. We hired a gardener; did we tell you? We travel so much nowadays that it is the best thing, really. He used to work for Kew Gardens, didn't he dear, but now he's retired?" She nudges her husband who nods with his mouth full.

"Right," Sherlock says icily, drops his cutlery onto his plate in the five o'clock position, and sweeps his gaze angrily around his company. " _What is going_ _on_?"

John tries to place a calming hand on top of his on the table, but Sherlock ignores him, narrows his piercing gaze as he homes in his attention on his mother. "You _never_ admit to the excesses of your shopping sprees, John has never in his life cared about gardening. Father is suddenly interested in surgical techniques that have nothing to do with my specialty, and I caught a whiff of your perfume on John's shirt collar in the car."

"Sherlock––" John tries but trails out.

Sherlock's piercing eyes are now pinning him in place. "Are you in on this? The fact that you're the first to try to placate me instead of looking vacantly surprised like you should, could point to exactly that." He withdraws his hand from underneath John's.

"It's your birthday, William," Violet hastily laments. "Let's not get into that, now."

"So there _is_ something to talk about. And you thought I would like nothing better for my birthday than the two of you to make John lie to me by omission."

George pushes his plate away.

 _Now would be a good time to come clean,_ John thinks. Judging by how the evening is going, he'll be sleeping in the guest room instead of next to Sherlock if someone doesn't defuse this quickly.

"Father?" Sherlock asks.

"We didn't want to worry you. You have enough on your plate at work. We know how much it means to you and how much trouble you go to with it to manage," George scrambles to excuse.

John can easily catch the slight, most likely unintended condescension in the words. It's just the sort of thing Sherlock will take literally—miss the intended apologetic message and cling on to certain words he perceives as malignant, such as 'manage'.

"Spit it out," Sherlock commands. "Cat's out of the bag, now; little additional harm in giving it a name, is there?"

"I've a minor health issue, but it's being taken care of."

Sherlock scoffs. "Obviously not minor, if you chose to talk to John about it behind my back. I assume it was for a consultant recommendation, since John doesn't personally treat anyone outside the OR?"

"I told them they should have a word with Henry Holcombe," John cuts in. Sherlock needs answers, and he's going to make sure he gets them.

"Holcombe's urology. Hyperplasia? No, that could be sorted out anywhere. Robotic surgery–– _adenocarcinoma_? _Dad?_ " Sherlock asks, now alarmed rather than angry.

George shifts in his chair to face his younger son, leans in and places a hand on Sherlock shoulder, which makes him flinch. He rarely tolerates being touched by anyone else than John.

"They tell me it shouldn't have spread, that they could even just keep watch on it for some time, but an MRI is needed first," George explains.

"But you're not happy with your current urologist, if you're looking for a second opinion," Sherlock counters.

"We really didn't want to worry you," George says and he sounds a bit regretful, now.

"I'll bet you had no qualms about worrying Mycroft."

"He knows, yes," Violet admits.

Sherlock draws in a slow breath; John can tell he's trying to control his anger. " _I_ am the surgeon. I operate on cancer patients, tell people they have a brain tumour. I tell them their prognoses all the time. In Malosa I worked on surgery of all types, yet you thought I couldn't be trusted to cope with this sort of news." Astonishment flirts with fury on Sherlock's features.

"That wasn't our intention," George says.

John pours the rest of the champagne into Sherlock's glass, his own, Violet's and George's. It gives him something to do.

"Are you going to want dessert, dear?" Violet asks Sherlock. They haven't even received their mains yet.

"If I want dessert, I am capable of ordering it myself," Sherlock snaps at his mother. "Or is this yet another example of how you think so little of my competencies? It was you, wasn't it? You decided to hold this piece of information hostage—or perhaps _withhold it as punishment_ _because of Christmas_ would be more apt?—because I wasn't toeing the line you insist on drawing on how you expect me to behave."

Without letting his parents reply, he then turns to John. "I suppose they came to you in confidence, then, knowing full well that you'd have to lie for them."

John can only shrug, tight-lipped, in reply. He's relieved that Sherlock’s tone, when addressing him, is resigned instead of angry. Trust and openness are still something they're both aware need to be cultivated meticulously. No need to repeat the crisis of miscommunication they'd had after John's return from Afghanistan and Sherlock's struggle with the halo. That unfortunately period had seen them both settling into deep emotional trenches and not being able to communicate their worries. If there is one thing that John has learned about Sherlock it's that prevention is better than putting out fires.

Two waiters approach their table, bringing in their main courses.

"When did you get the news, George?" John asks. Sherlock is unlikely to drop the subject soon, so best just muddle through this.

"Doctor Michael called about the biopsies last week and I didn't like her hemming and hawing about the MRI. There's a urologist or two at the Royal Marsden but they don't have this surgical robot, and the patient organisations are all stressing its importance. We thought John might––" George explains, only to be interrupted by Sherlock.

"Holcombe's an old fool who opposes erection-preserving robotic surgical technique," Sherlock cuts in.

"Table manners," Violet says quietly.

"What? Since we apparently need to discuss prostates, then we can hardly escape their function. This is no time for prudishness." Sherlock sinks a knife into his turbot with surgical precision. His voice is loud enough that the nearest tables have picked up on their conversation, and some of the patrons are giving them half-amused or confused looks.

"Perhaps we should look for other options than this Mister Holcombe, then," Violet says with a strained, low voice. "John dear, your fish looks fantastic."

"What is your total PSA value?" Sherlock asks George.

"43."

"Oh." Sherlock's fork halts and he's frowning at his plate. His still brewing rage seems to have been at least temporarily derailed by the realisation sinking in that the prostate-specific antigen value is alarmingly high. He has distracted himself from the gist of what's going on so far, but John can see the cogs turning, information being filed away and analysed. Whatever peripheral conflict may be going on about the manner in which the news was delivered, the most important fact to consider is that Sherlock's father has cancer. That realisation looks to be now sinking in properly.

"Biopsy results?" Sherlock asks in a clipped tone.

"Some grade or other," Violet cuts in. "I didn't understand what relevance that has."

"That grade largely determines the prognosis and the next steps in treatment. For God's sake, _think, woman!_ What was it?" Sherlock presses angrily.

Violet is aghast. "William! I understand you're upset––"

John can see that Violet's repeated refusal to use Sherlock's name is adding fuel to the fire.

"I'm not _upset_. I'm trying to do exactly what you sought from John; to formulate advice on the best medical solution based on the facts. Need I remind both of you _again_ that I am the surgeon at this table, not John? Perhaps that little fact has, yet again, escaped your attention, just as every other thing that has happened to me since I was, I don't know, _five_?!"

Sherlock _is_ upset, very much so, and John seems to be the only one currently understanding the reason why. He's the one who sees through the deflection, the reactive anger and the righteous indignation. Sherlock is hurt by the truth being concealed from him, and now he's also trying to cope with a situation he has never been in before. Granted, Mycroft had once ended up on his operating table and they couldn't turf the case to anyone else, but the danger had been over soon, and it was very clear what the right course of action was. More than that, it had been Sherlock’s own medical skills that had resolved the problem. He doesn’t have that option open to him now since he's lacking pertinent data, and John knows this will be ramping up his anxiety.

There are also all the things connected to Violet he hasn't had to deal with live since Christmas. Even without any novel drama, this night could have been a test to destruction of that mother-and-son relationship, judging by how precarious things have been.

Sherlock pushes his cutlery underneath the edge of the still hot porcelain plate.

George regards his son with the tired patience of a man who has been disappointed many times by similar conversations. "Don't make a scene, William, please. Let's just have a nice birthday dinner and talk about this later."

Sherlock crunches up the linen napkin he'd placed on his lap into his fist and puts it on the table as he stands up. "That's just the thing. I've told you countless times it's _Sherlock_ , also a name the two of you gave me, but apparently it was just for ornamental purposes. Lord forbid _I'd_ want to pick which one to use."

"I guess we never quite understood why you changed it. After so many years, you must forgive us if it's a bit hard to remember you did," Violet tuts.

"I changed it, when I realised that _William_ would never amount to anything because nobody believed he was fit to even tie his own shoelaces. _Sherlock_ had to step forward, because he at least had a chance to make something of himself. And I have, as a surgeon whose opinion should have counted for something with you. Unfortunately, it seems that with you two, Sherlock will always be side-lined in lieu of someone who was _precisely_ as weak as you had convinced him to be."

It's not the first time Sherlock has walked out of a social situation, but usually he at least remembers to grab John's sleeve and drag him along when he makes a dramatic exit.

Not this time. This time, he's too furious, and John has never heard him lay down the law to his parents like this. He tolerates them, ignores them, grinds his teeth at their way of always treating him as the little boy they need to shield from the world. There has always been a tension between them, one Mycroft sidesteps but which Sherlock seems to come up against time and again. Some of this lingering bitterness John thinks he can now understand well, having seen it up close and personal this Christmas. Even if John stripped away layers of subjectivity and the way time distorts memories, he is left with the impression that George's approach to Sherlock had been a sort of a benign neglect and ignoring of Violet's near obsession with the demands of her special needs child. They had meant well, but not quite understood their brilliant but socially awkward son with severe sensory issues. They certainly never encouraged him to reach for a thing he wanted if it would have been challenging even for a neurotypical person to achieve. Witnessing his reaction to John calling him disabled soon after they'd met had hammered home in one swing how such things pierced his armour and could lead to extreme reactions.

John is adamant that Sherlock doesn't need protection the likes of which Violet still insists on trying to inflict on him. He's a trained professional, and he's survived worse emotionally than accepting the news of a family member's illness.

"Good night and good luck, then," Sherlock scoffs. "John, you stay and tell these people what they think they need to hear from a doctor whose opinion they value."

Sherlock doesn't even look back as he marches out of the restaurant.  
  



	2. Father and Son

John comes home two hours later. He tastes of chocolate and espresso when he gives Sherlock a kiss upon finding him on the small balcony connected to the upstairs bedroom.

Sherlock is too angry at his parents to bother to complain that his husband had indulged in dessert without him. His head is swimming with nicotine from his electronic cigarette—a far cry from the real stuff—on top of the headache he's given himself by pounding at his laptop for an hour. After his cab ride home, he'd tried to lose himself in some research loose ends, but his thoughts kept slipping back to his family. He knows he should spend less time staring at screens but needs must. Being in the OR where he can freely adjust his microscope to match his visual needs doesn't give him a headache like screens have begun to do after Malosa.

"You okay?" John asks, frowning at the sight of his cig.

"Evidently not," Sherlock says. Usually, he goes for nicotine patches, especially if he's at work, but right now he wants the faster high that only cigarettes or this pathetic sanitary equivalent will give.

John then drops a bomb: "George is in the kitchen; he came with me."

"Just him?"

"Yeah. He wants to talk to you."

"Bad luck, then, because I don't want to talk to him."

"Sherlock… He's just had quite frightening news so maybe cut him a bit of slack, yeah?"

"I've done nothing but cut them _a bit of slack_ all my life, not calling them out on putting me down." He shrugs. "Why would he want to talk to me _now_? After all, he was more than prepared to lie to me before. It's as though it simply would never have even occurred to them to come to me for a medical professional’s opinion. It sort of says it all about what Father thinks of me. I always thought he was… different from Mum. Funny how I'm starting to realise that, now— _finally_ , at age thirty-six." He shakes his head.

"Well, you've been talking to Joanna, and you've had good experiences lately with people. It seems logical that you will no longer put up with people who disrespect you."

"You don't make a habit of doing that or underestimating me. Father and Mummy, however, are the reigning champions of it."

"Believe me, I know how parents can drive you up the wall. Sisters, too."

"Not to mention idiot brothers. I presume Mummy sent George here to tell me off for being rude."

"I doubt that, but I don't want to be the messenger. Just have a word with him?"

" _Fine_." Sherlock's tone should make his reluctance clear.

John disappears back into the warm, inviting flat, leaving Sherlock in the chilly wind on the balcony. At least the cigarette is warming him up. He's glad John hadn't mentioned it. He did send Sherlock a bunch of articles last week about electronic cigarettes' purported bad effects on health, but they have still got to be less harmful than the real thing. Right now, Sherlock would love the real thing, or alternatively something illegal. It’s times like these when cravings hit like a tidal wave.

Eventually, his father opens the door and joins him on the balcony. Pursing his lips, George gives Sherlock a nod, looking as though he doesn't really know what to say. 

Sherlock does. "I hate how all the two of you need to do is show up and everything turns back into what it was when I was a child."

 _The dismissals. The pity. The belittling._ They did everything for him, and in the process robbed him completely of a sense of self-reliance, confidence and capability to manage. It took Victor and hitting a rock bottom with where his life was headed to take the first step in his life to work out what it is that he wanted instead of trying to adapt to what was deemed safe and suitable.

"I think it works like that for most people. Mycroft berated your mother the last time we had a meal with him; she told him to sit up straight and take his elbows off the table."

Sherlock huffs. "Not the same. Will you ever accept where I am in my life? That it wasn't just the result of an army of professional help and the rules being bent to accommodate me? That it's not an accident where I've ended up? That I didn't stop changing and learning things when I left home?"

"We're very proud of you," George says, clearly puzzled. "We would have been proud no matter what you made of your life."

Sherlock glares at him. "That's just insult to injury that you would have praised me for much less than I'm capable of. I can't believe this, especially after what happened with Mycroft."

His father's eyebrows knit together. "With Mycroft? What do you mean?"

 _Bloody hell._ In his anger Sherlock had forgotten that they agreed that it was best their parents didn't know who had handled the surgery for Mycroft's acute traumatic subdural haematoma. Sherlock was within his ethical rights to operate since delaying while waiting for another surgeon could have cost his brother his life, but it was still generally against the rules to treat a family member.

"When he had a cerebral haemorrhage," Sherlock finally breathes out, watching the passing cars in the darkness.

"When was this? We haven't heard of such a thing!"

"He might have told you it was just a concussion or something. His London residence was being renovated."

"I remember him telling us he'd been checked out at a hospital after having a fall, but that's all. Sherlock, what are you talking about?"

"He had a rapidly expanding acute subdural haematoma. Was brought in unconscious and had to be taken in for emergency surgery. Guess who was the lucky neurosurgeon on call that night? John was on anaesthesia." He refrains from sharing how John had helped him keep his head on straight when the discovered the identity of the patient in his OR. "I had to do it. A delay would have been fatal."

His father stares at him, shock making him pale. "You saved his life, then." A statement, not a question.

" _We_ did. We saved your _normal_ , golden boy."

George Holmes grips the balcony railing with both hands, gathers himself. "I don't quite know what to say. I wish he had told us. I wish _you_ had told us."

"I guess both of us have experience with lying to family members, then. Don’t be surprised that we sometimes choose to spare you from knowing everything, too. Do me a favour and don't tell mother. All she'd do is get riled up and angry at me."

His father reaches out for his shoulder, but Sherlock shifts away. "You said you were proud of me. Sometimes I feel that you don't have a right to be proud for something you and Mum tried to shoot down, and Mycroft too. I know that all three of you assumed I would fail if I chose medicine." He sighs. "John's the only thing you haven't told me to be _sensible_ about." That had been Mummy's favourite phrase when it came to trying to coax Sherlock out of doing something that he wasn't good at or where there was a risk of conflict with other people.

"We did worry about you and him, initially; how could we not, after what happened with that Victor?"

"I suppose that was all my fault, too, then? Innocent, hapless lamb led to slaughter."

"No, of course not." His father's denial doesn't sound entirely convincing. "We just worried whether you knew how to make…well, sensible, responsible choices. Your mother has never been happier than at your wedding, I promise."

"Because I was finally off your hands? No longer your responsibility? Because I had a new _minder_?"

"Sherlock," his father says sternly, "I will not apologise for wanting to spare you from how people can get when they don't understand someone who's different. How they can take advantage of others."

"No, your solution was to hide me away, wrap me in cotton wool."

"You are not being very fair to your mother. For years, she dedicated her life to looking after you."

"And I'm tired of everyone defending her as though she could do no wrong. You think dedicating her every waking hour to hounding me somehow automatically made everything she did good or alright or beneficial? You know why I never complain to you about anything at work, or about what happened after John came back from Afghanistan? It's because while the _'I told you so's_ ' may not be said out loud, they're there. Even _I_ can read that much between the lines."

He never told his parents John got shot. Mycroft saw fit to divulge that, and Sherlock is still angry for that. Thankfully, living mostly in Zurich prevents his brother from dabbling often with being a self-appointed meddling busybody—not because he really wants to help resolve issues, but because it makes him feel important. Sherlock suspects he has inherited that need from their mother.

Pointing at his temple with his forefinger, he exclaims: "I don't need you or anyone to tell me all the things I can't do, to remind me of all the things I'm bad at, because after years and years of having to listen to that, I assure you it is archived, indexed and easily accessible _right here_! When were you going to tell me about the PSA and biopsy? After you saw someone at King's? Wouldn't it have been convenient if we'd just bumped into each other in the foyer? You could have just dropped the bomb casually."

His father's expression is tighter, now. "Perhaps your propensity for making a scene meant that we certainly didn't want to do it at Pétrus."

"You took care in telling John first, somewhere private, but not me," Sherlock points out. "Do you have any idea how awful a position you put him in?"

"I'm sorry. This whole thing has been…taxing. Violet insisted we go see John to get some more names; you know how persuasive she is."

His mother seems usually as oblivious about the emotions of others as Sherlock is. Thanks to her off-hand dismissals and the turfing of things to the therapists employed for Sherlock when he was young, it always felt like Mummy would never listen and that his emotions were just a problem to be quickly sorted out by somebody else.

"That’s your fall-back position, as ever. You blame her," he says in a resigned tone.

 _'We're all a sum of our experiences',_ Joanna had said when Sherlock had told her the story about adopting his second first name when he was accepted into Cambridge to study medicine. There was nothing wrong with William Holmes, until other people told him there was. At the start of medical school, he wanted to shed that baggage, and with everyone else he could, but not his family. For them, he would always be the troublesome child they watched grow up.

John widens the gap in the balcony door and sticks his head in. He has removed his tie and his jacket. Sherlock likes the sight of him in just a dress shirt.

"Everything alright?" John asks.

Sherlock nods.

"I'll make some tea," John says amicably.

"That'd be lovely, John, thank you," George hastens to reply, visibly relieved that John's appearance seemed to thaw the icy atmosphere on the balcony.

"Do you want your jacket?" John asks Sherlock. He's in his shirtsleeves, too; the cold wind seemed to cool his anger by turning emotional discomfort into physical.

"No, we won't be long."

The things John does to look after him don't bother Sherlock because he has chosen John, _loves_ John, instead of the man being foisted on him in some professional role. John is his buffer zone, his cushion between the world and himself. His safe haven. Sometimes the thought of needing him like that irritates Sherlock, but isn't that one of the cornerstones of all relationships—a hopefully benign mutual dependence? Before the halo vest crisis Sherlock had assumed that there were very few positive things that John gleaned from being with him, that there wasn't much he could help John with. He had always assumed that being in love with him was John's defect, one that helped the man endure having to give so much of himself, of having to do so much work for the both of them in their relationship. It took a long time for Sherlock to believe that they met if not halfway, then at least somewhere around the middle when it came to what each got from being together. It still astonishes him, what apparently he is for John, and on a bad day he still doubts it. On a good day… it's all fine.

Today does not feel like such a day. As much as he tries to combat the sense of being a burden, the way he's been treated is making his confidence brittle now that the brightest edge of fury is abating.

' _Perhaps that is the problem'_ , Joanna would probably point out. Once again, Sherlock has let other people determine whether he has a good day or a bad day.

He has changed some of his opinions about himself, but it's hard to believe he could change those of his parents. Yet, Joanna insists that he should at least try. He’s angry enough now to try and has enough perspective to want to use that energy more constructively than just acting out and confirming their assumptions about him.

"Dad." He hasn't called his father this since he was in his teens but tonight's he's already done it twice.

George Holmes turns to face him.

"You said you wanted to ask John for some names. Can you explain again why?" He wants to hear George's take on the situation instead of having to base his plan on Violet's hysterics.

"We wanted to get a second opinion because we're not getting a clear idea of whether to go for surgery or not. Mycroft has asked some of his contacts and given us these names," George says and begins digging around his jacket pocket. He produces a slip of paper with four names on it and gives it to Sherlock. "We wanted to ask John what he thought. He mentioned Holcombe, too."

The first Sherlock doesn't recognise, but he scoffs at the second. "Tretton's a berk." The man works at King's, and his research and surgical expertise has more to do with the kidney than the prostate. The third is Holcombe; obviously John doesn't know enough about urological surgery to be aware of how old-fashioned that man is.

Sherlock scrutinises the fourth. "Hallard's good. _Very_ good."

"We know," George replies. "At least it's impossible to get an appointment with him at his private practice; the queues are very long."

"Leave it to me," Sherlock says, and pockets the list. "He thinks he owes me a favour."

Sometimes, people offer quid pro quo to be polite and don't actually expect ever to be asked to deliver, but right now Sherlock doesn't care. Besides, as far as he can tell, Hallard had seemed genuinely keen, even given Sherlock his personal calling card on the day his son, Oliver, was discharged from King's. Oliver, a 15-year old outstandingly promising alpine skier, had a shunt which had been installed when he was very small, and a relatively minor fall on a slope had detached the drain hose from the regulator valve. As a result, he'd been given a new shunt but the first replacement had become infected. After two months of treatment, the infection showed no signs of receding. The worried, angry father took his son out of The National, and contacted King's to see if Sherlock was available for a consult—his name had popped up in conference programs as a shunt expert. After much contemplation—including a few stressful, sleepless nights—Sherlock had decided to recommend installing both a new shunt and a so-called Rickham Reservoir to treat the infection by locally infusing antibiotics into cerebrospinal fluid to complement the intravenous ones Oliver was already getting. The unusual move was a success, and the family insisted on eternal gratitude.

Eight months later, Oliver had sent Sherlock a medal he'd won at the youth European alpine cup. It hangs in his office. ' _If you ever need a urologist, call me_ ,' Mark Hallard had told him, offering his card.

"I will get you an appointment, but I want to attend it as well," Sherlock announces. "You or Mummy won't know what pertinent questions to ask, but I do."

"I would like that very much. I just hope you're not uncomfortable discussing such a thing as my––"

"It's just an organ, Dad. A kidney's an organ, a brain's an organ, a prostate is one. I have one, John's got one, you have one. And no, I am practically never _comfortable_ discussing people's health issues with them, but I have been trained to do so; it's my _job_. Mycroft is the one who gets squeamish; he likes to pretend he moves around in medical circles as though he were one of us, but he does still faint when he sees blood." Sherlock rolls his eyes for further dramatic effect.

His father smiles. "The matter's settled, then. Thank you, Wi–– _Sherlock_. Sorry. It comes so automatically."

"Doesn't matter. We all have our bad habits," Sherlock replies, taking another puff from his electronic cigarette.

"Violet used to smoke; did you know that?" George asks. "She quit when we started expecting Mycroft."

He hadn't known that. "Speaking of her…." Sherlock exhales a stream of smoke into the night air. "How’s she _really_ taking all this?"

He can see his father shrug at the edge of his visual field. "You know; the usual, _we can do this together_ pep talks and fussing about to distract herself. That's why she was being so… insistent at Christmas, I think. She's scared, and there is little she can do; this falls under neither of our expertise, and she doesn’t like to be reminded of mortality. We’re getting old, son. It’s sort of crept up on us, and it’s not something she wants to think about. Neither of us wants you or Mycroft to have to worry about us.”

"That’s stupid. We’re not children. Death and illness happens to all of us, and I deal with it all the time since it’s part of my _profession._ I just can’t understand why it didn't occur to you and Mummy that I could help explain things, plan for possible treatments? Why would you go to John?"

"We wanted to protect you."

"I don't even know what that means, since I assume that I would still eventually have found out what was going on. I mean it, Dad: I’m done with being treated this way. I’ve avoided saying this to you both for too long because I couldn’t deal with being reminded all the time that in your eyes, I am someone who needs protecting from what is just life. I don't need that from John, and certainly not from the two of you."

George looks a bit startled. "Look, about Christmas: I know Violet doesn't always quite see past the two of you being her little boys. She says she wants you not to worry about work things when you're home; she just wants the family there like the way it was when you were small. I know it irritates you, the way she behaves, but that’s just her way of saying she misses you and she doesn’t know the adult you very well. It was hard for her, seeing you go through so many things, the drugs and all, and she prefers to deal with the William she knows how to manage."

" _Manage_ ," Sherlock spits out venomously. "Nobody manages me anymore. Not John, not her. She has always thought that the most I could achieve in my life in her eyes is finally managing to fool people into thinking that I'm normal like the lot of you. She won't see my real achievements as long as she thinks I'm letting others see how _defective_ I am. But what if that's the wrong approach? What if that was _always_ wrong? If my standing up to her upsets her then so be it. And, you need to stand up to her when it comes to your treatment—don't let her decide for you. I see such things all the time in my work: husbands and wives not telling each other things until it’s too late; children having to make decisions on behalf of their parents: should we respect a DNR? Should we move an elderly relative into a nursing home? I know this is what families _do_ : bicker and lie and make things difficult, and it's _tedious_. Best get started by being honest with each other, and us."

He's getting cold so he slips through the door into the sitting room, extinguishing the cigarette. He suspects he's had enough nicotine to make him so restless that he can't sleep even with John's calming physical presence. His husband will want to settle to bed soon; they both need to be at work before seven-thirty.

John has arranged three mugs of tea and some almond biscotti on the breakfast bar. They grab seats and John and George begin making small talk which Sherlock tunes out. He sips his tea quietly, aware that John has chosen Darjeeling for its lower caffeine content. It's reassuring, having someone like John reminding him to look after himself as long as it's his choice and not someone condescendingly telling him he can't be left to fend for himself. That's John's brilliance: anticipating, sensing his needs and subtly addressing them. Together, they are better, as long as John doesn't insist he knows best what Sherlock wants or needs or should be shielded from.

After the tea, George makes a remark on how late it is. Escorted to the door by the two doctors, he dons his flat tweed cap. John slips an arm around Sherlock's waist, which makes Sherlock realise how tired he is. He is very tempted to rest his temple on John's shoulder but since his husband is so much shorter that would just give him a crick in the neck.

"Goodnight, Dad."

"Goodnight, Sherlock."

Not _'my boy_ ', or  _'son_ '. No hugs. Calling him _Sherlock_ means more than any physical display of affection ever would. It means that they are respecting his right to define who he is.

"Is Mummy angry I left you at the restaurant?" he asks, blinking and squinting his tired eyes.

George smiles, his dimples drawing up in a way that only happens to people who smile a lot. "Yes, and no. She's used to your dramatic…exits. After all, you take after her in that respect. We dropped her off at the hotel." George takes a pause. "We don't quite know what to do with you sometimes; that hasn't changed. Maybe you need to keep reminding us of––well, these things we have talked about tonight. She was opposed to me talking to you tonight, said that we should just give you some more time to get over your episode."

It grates on Sherlock that she still won't take it seriously when he's angry or dismayed. To her, everything is just him being his defective self—everything is a symptom which will pass on its own.

John is smiling with tired eyes. "That's parents, alright. All they see when they look at you is when you sat on an ant mound when you were four." 

George chuckles. "You are quite right, John. Goodnight."

The door closes behind him.

Sherlock yawns.

"Hatchet buried, then?" John asks.

Sherlock plucks at a stray bit a thread in his shirtsleeve. "Momentarily, I guess. Like most changes, it’s going to take time and constant repetition to get it through their heads. They both have more concerns, now, than just me; perhaps it will help give them a sense of perspective." He tries not to think about the fact that his father has cancer. Maybe that fact is more responsible than the nicotine for the ominous restlessness he feels.

"Oh, I forgot," John says as they make their way back to the kitchen, "I swapped with Jacobsen, so I'm gassing for your biopsies tomorrow. Extra birthday present."

"Isn't that a bit pedestrian for the Clinical Director of Operative Services?" Sherlock teases.

"Beats gassing for Anderson's shunt revisions."

"Of course." Sherlock groans. "God, if I had to listen to him all day, I'd probably lobotomise myself with a scalpel."

"You okay?" John asks after putting their mugs in the dishwasher.

"You are probably expecting me to say no. I don't know. I want to do something, not sit around waiting. I know prostate cancer doesn't often require a quick intervention, and his case doesn't seem to be very aggressive, but…"

"But it's already been over a month since they measured his PSA," John concludes.

"I'm going to call Mark Hallard tomorrow."

John nods and turns off the lights in the kitchen.

While brushing his teeth, Sherlock makes a mental note to start researching current treatment protocols of prostate cancer, and to ask his father for a copy of his lab and biopsy results to be passed on to Hallard.

Instead of just demanding respect, he is going to prove why he deserves it. He can do this, for his father. It'll be the Holmes men versus cancer, and instead of being side-lined, he's going to be the war general.  


	3. Into Battle

A week later, Sherlock pulls open the door to the urology outpatient clinic on the lower ground floor of Chelsea and Westminster Hospital. After asking at the reception counter, he is informed that Mister Hallard sees his patients in appointment room six. After he strides down the corridor and turns a corner, it becomes apparent that he could have just walked down the hall to find the right room since George is already sitting in front of it.

Sherlock is relieved to find that Mycroft isn't in attendance; perhaps his dad really has accepted the premise that Sherlock just might be the only genuinely useful member of the family in this situation.

George hasn't picked up any of the magazines or leaflets on offer on a table nearly. He is just sitting, looking expectant, his usual wax coat folded over his knees.

After a curt hello, Sherlock offers to take it and hangs it up on a rack.

"You don't suppose it could get stolen?" George asks.

Sherlock raises a brow and takes a seat. "Dad, no one in their right mind is going to want to steal that coat. There are buttons missing." At least his father isn't wearing wellingtons.

"I doubt that all people visiting hospitals are in their right mind," George replies. "It would just be a very unpleasant surprise to have to put it with this weather without a coat."

"Dad, it's _fine_ ," Sherlock huffs.

A door down the hall opens, and Sherlock gets what really does qualify as a nasty surprise: he quickly recognises Violet as the woman emerging from the ladies' room.

"There you are!" Violet exclaims. "We worried you wouldn't make it. London traffic and all." She glances pointedly at the wall clock, as though showing up precisely at the appointment time is somehow the height of bad manners.

Sherlock doesn't stand up for the hug she is undoubtedly pining for. "Mother," he says politely with a nod.

She remains standing and checks her watch as though more than a few seconds could possibly have passed. "They're running late. Terribly tardy, I'd say."

"I've yet to see an outpatient clinic with a realistic schedule," Sherlock replies. "And surgeons are the worst off since they might get stuck or called into the OR to help a trainee or a morning operation might run overtime."

"But this is a urologist, isn't he, and not a surgeon," Violet corrects him.

Sherlock breathes out slowly, refusing to get provoked. This is his territory, and he will not embarrass himself by losing his temper just before having to face an esteemed colleague. "Urologists are all surgeons, too. It's an operative medical specialty just like neurosurgery."

"Carole Michael doesn't operate, does she?" Violet asks George. "She's who we saw at Royal Sussex County."

"I don't know," George says. "She did say she doesn't do prostate removals."

"Smaller hospitals usually do cystoscopies, circumcisions, prostate incisions and resections for benign hyperplasia, but not major surgery."

"How do we know this man is good?" Violet asks Sherlock. "I know he was on Mycroft's list, but surely there are many experts in London, since this a very common disease," she then announces.

"Hallard leads the National Institute for Prostate Cancer, and he has pioneered several surgical techniques in the field, including being the frontman of robotic radical prostatectomies."

"Radical? What do you mean, radical?" Violet asks, looking unsettled.

Before Sherlock can answer, the door is opened not by a clinic nurse but Hallard himself. Even taller than Sherlock, about a decade older than him and a natural ginger, he is a memorable-looking man. The son, Oliver, is a red-headed, freckled thing as well, and his mother a petite, bubbly, blonde barrister.

Mark Hallard's smile is wide and welcoming. "Mister Holmes," he invites, "though perhaps I should put that in plural."

Sherlock lingers behind as George shakes his colleague's hand and is invited to enter the clinic room.

Violet shoves herself in next with a nervously enthusiastic shake of the urologist's hand.

The handshake Hallard gives Sherlock is firm and long. "Good to see you, though of course the circumstances could be better," he offers. "Oliver is in Cervinia, training for the World Cup. He's doing great, though not much for studying for his exams. We have a tutor now who travels with him. Teenagers," Hallard laughs.

"I'm glad to hear he's doing well," Sherlock replies, and he means it. It is rare that he gets to hear what happens to his patients years after he has operated on them.

Hallard's clinic nurse brings in a third chair, placing it off to the side. Sherlock takes it.

Violet and George have occupied the ones across the desk from where the consultant sits.

"I've received a copy of your records from Royal Sussex. It appears that we're dealing with what we call an adenocarcinoma of the prostate, the commonest type of prostate malignancies," Hallard starts. "Please ask me to clarify if I use an unfamiliar word, by the way. I'm sure you are used to medical jargon, but it's imperative that you understand what is being discussed."

"Yes, yes of course," Violet cooed.

"Could you tell me in your own words how they came by this diagnosis?" Hallard leans forward, placing his arms on the table and looking expectantly at his patient.

"I was having–––" George starts.

"He was having to do _three_ trips to the toilet every night, kept us both awake," Violet cuts in nervously. "I told him he _has_ to have it checked out, get some of those pills so many of his friends are on which seemed to work so well."

Hallard shifts his gaze quickly back to George. "They suspected hyperplasia? Benign enlargement, that is?"

"Yes," George replies, "and they said all the laboratory work was–––"

"Just _routine_!" Violet complains. "Why do they not take these samples from all older men? I don't believe a word that Doctor Rose — he's our GP — said that it wouldn't be beneficial, somehow. They test women for breast cancer all the time and if that's beneficial then why not––"

Sherlock clears his throat sharply, making Violet pause. "The question was for Dad," he points out.

Violet gives him a disapproving glance but doesn't start arguing.

Hallard's focus hasn't wavered from George. "They found an elevated PSA value?"

"Yes, so Miss Michael recommended a biopsy."

Hallard leafs through the record copies. "And the result is what I have here on the pathologist report. Unfortunately, it showed what we call Gleason class three patterns: moderately differentiated cells which infiltrate out of glands. That is not, however, anywhere close to the most aggressive types of prostate cancer. The prognosis of every case depends on more than just the Gleason score; imaging will play a role as will clinical findings and the pathologist's report on how many biopsy samples contained these changes."

Hallard pauses, presumably to allow time for questions. There are none.

"How are you feeling, Mister Holmes? Are there any other symptoms besides the ones caused by the enlargement, namely having trouble urinating?"

"No, not as such."

"It's entirely possible that there is both benign enlargement and some malignant growth, explaining your frequent nightly trips. I see they managed to squeeze you in for the bone radio isotope study before today's meeting?"

"Yes, that was two days ago."

"Thankfully, our radiologists have had time to deliver their statement." Hallard clicks through something on the computer. "The bone map did not show any spreading—bones are the first spot this type of cancer usually sends metastases to."

"Shouldn't there be an MRI?" Violet asks. "It could spread to other things, couldn't it? How will you know without an MRI? Is that not the best way to image things?"

"That is not routine because it cannot show whether the cancer has spread to the surrounding lymph nodes which would be its first stop. Miss Michael reports no palpable anomalies in the prostate, nor were there abnormalities in the ultrasound. I will repeat both exams today, of course."

"You must tell us if we should go for the surgery," Violet insists. "Miss Michael just wouldn't give us an answer."

"All in good time, Mrs Holmes," Hallard says with a reassuring smile. "We divide prostate cancer into four risk categories. Factors determining which group a patient belongs to include how big an area of the prostate the tumour affects, whether it has spread to local lymph nodes, how high the PSA value is and what the Gleason score is. Sometimes, different areas in the tumour differ in how well-differentiated the cells are…" Hallard trails out, suddenly frowning. "Mrs Holmes?"

Sherlock shifts his attention to his mother.

Violet is feverishly digging around in her purse, finally producing a paper tissue. Tears are flowing down her cheeks, smudging her carefully applied makeup. George leans closer to her, drapes an arm around her shoulder as she dabs her face.

"There is so much information, and it's all so confusing," she complains, tears thickening and straining her voice. "I just want to know what to _do_!"

"You don't need to do _anything_ , except allow Mister Hallard to do his job," Sherlock tells her. His tone is harsh, but he can hardly help it. This is precisely why he's needed here — all his mother does is fuss uselessly.

Violet blows her nose. Instead of calming down, she now seems to be dissolving completely into tears.

"Perhaps I might examine George, now," Hallard suggests, exchanging a look with Sherlock, who stands up.

"Come on," he tells Violet. "Let's go find some tea and give Dad some privacy."

"He's my husband. Nothing I haven't seen before," Violet protests. The crying has made her voice a bit nasal. "I was there when we first spoke to Doctor Rose and we saw Miss Michael."

Sherlock is not going to stand down. "Mummy," he pleads. "You're a mess, and it isn't helping. Let's go."

Reluctantly, Violet stands up and grabs her purse. George pats her arm and she starts making her way to the door.

"I will call you back in when we're done," Hallard tells Sherlock, who nods.

He is not very bothered by the idea of the exams needed even if this is his father—after all, he has performed similar things on patients earlier in his career—and if the patient here was John, not even being held at gunpoint would get him to leave the room. But, perhaps it's a good idea to give patient and physician a chance to speak alone. After all, he often signals to his clinic nurse Marie to try to get hysterical or overbearing family members out of the room so that he can have an honest, constructive dialogue with his actual patient.

Once in the corridor, Sherlock stands with his right hand clasped around his left wrist behind his back, waiting for Violet to sort herself out in the ladies' room.

She emerges looking only marginally calmer. "That was uncalled for, what you said in there," she chides her son. "It's important to face this as a family."

"Not in a way that makes it more about you than about him. He worries more if you worry too much and get emotional."

Sherlock understands this after years of living with John. The way their moods and concerns have become intertwined has been challenging and educational to explore. When John is out of sorts, Sherlock gets that way by extension, too. "Maybe you should sit out the rest of the appointment."

" _Of course not_! I need to know what happens next."

"And you will be informed. Dad's clever, and Hallard's good at explaining things."

They make their way out of the outpatient clinic to the main hall, where a small cafe catering mainly to patients and family members sits in a corner of the busy entrance area. Sherlock gets a cappuccino, and Violet some Earl Grey.

He checks his email on his phone and replies to a text from John asking how things have gone:

**[SH 10:42] Mid-appt. Will keep you updated.**

John replies quickly:

**[JW 10:44] Mycroft there?**

**[SH 10:47] No, but my mother is.**

**[JW 10:50] Uh oh :)**

Sherlock's lip quirks up, but thankfully Violet doesn't notice. She is too busy using the mirror on her compact to fix up her lipstick.

After fifteen minutes have gone, Sherlock pushes away his cup and stands up, straightening his jacket. "Shouldn't have taken more than this to do a full status and ultrasound. You could stay here," he suggests tentatively. "I promise you will be kept updated. It's not going to help if you just get upset again."

He secretly relishes using the u-word about her, since she has spent years dismissing his feelings with it. Sherlock does understand why her composure is crumbling: every time John has been ill or injured, Sherlock has had severe trouble keeping is wits about him and not dissolving into a frantic emotional mess. But, he has kept it together because John has needed him. He knows he can do that, now, for his father. Violet isn't helping because her way of coping is to fuss and distract herself, to micromanage others and steamroller over them. His father needs a chance to be involved in the discussion regarding his health, and Sherlock doubts that Mummy—especially in her current state—would allow that to happen.

Violet looks away, lips pursed tight, but doesn't stand up.

Sherlock decides it's enough of an answer and strides back to the outpatient clinic. His timing is good: just as he is about to take a seat in the hallway, the door opens and the clinic nurse beckons him back in.

"Is Mrs Holmes joining us?" she asks.

"No," Sherlock says in a tone that invites no arguments and goes to take the seat Violet had vacated.

George gives him the tired, relieved smile of a man who's just been poked and prodded rather intimately.

"Time for decisions," Hallard says, rubbing antiseptic gel into his hands before retaking his seat across the desk.

"I think we can be fairly certain that the tumour is limited to one lobe. You are in very good general health, with only elevated blood pressure requiring medication and it is currently within the target range. Your age isn't very advanced, your Gleason score is not highly malignant. Your total PSA value is, however, 12. Not exceptionally high, but it could point to your risk level being moderate instead of low. But, we give the Gleason score the highest predictive weight. What I would suggest is treating this with radiotherapy preceded by adjuvant hormonal treatment. That combination does carry a risk of changes in the function of your bowels and your urine tract, but those risks are naturally bigger with surgery. I believe we could reach complete remission with just that, sparing you from surgery. Medications for benign hyperplasia can be combined to ease the symptoms which originally lead you to seek treatment; they shouldn't be caused by the tumour. And, if we are unlucky and this comes back in the future, then we will go for surgery but the radiotherapy and the hormones will already have slowed tumour growth, curbed its size and improved your chances even if we're looking at a more aggressive cancer than it appears to be based on the information we have now. How does that sound, George?"

"I would prefer to avoid a big operation, yes."

"Prostate surgery has advanced much from the days of many patients losing their bladder control and erectile abilities. With robotic surgery we can now even avoid a big incision. But, as I said, I think we can very safely avoid an operation while still achieving a good guarantee of this never bothering you again, once the radiotherapy is over and done with."

Sherlock breathes a sigh of relief. A radical prostatectomy for a patient such as his father who is not very old and in good general condition wouldn't be a very high-risk operation, so the biggest consolation comes from the fact that everything points to this cancer not being very aggressive or widespread at all.

"If we examined the prostates of a hundred men who are ninety-five years old, we would probably find an adenocarcinoma in nearly every one, or all of them," Hallard adds. "But, some of those cases would never have required any treatment in their lifetimes. That's why we don't screen everyone for PSA—we'd find cases which would never threaten the patient's life or health in any significant way, but we'd probably end up subjecting some of them to treatment with significant risks just to be on the safe side. It was very good, however, that we found yours before it developed further. There are some features in it which mean that it's not the most innocent type. But, I'm confident it's very curable without compromising your health."

"Alright," George accepts. "Thank you, Doctor Hallard."

"Could the radiotherapy be administered at Royal Sussex County?" Sherlock asks.

"Yes, I suppose it could be," Hallard replies thoughtfully. "I have to look into it."

"I would prefer to have it here, if possible," George says.

Sherlock is surprised by his sudden determination. He loves his father, but he has always disappointed him by being such a yes man, especially when it comes to Mummy.

"That can be arranged," Hallard says. "We have an oncologist here specialising on prostate cancer. Joanie, could you bring up Emma's bookings and see if we could give Mister Holmes an appointment straight away?"

The nurse pounds away at her computer on a small desk in the corner. "Emma's got some time this afternoon; I could call her secretary to combine two of these available check-up slots for a first review appointment."

"Best get started right away," George comments.

"Indeed," Hallard confirms. "I will mark my notes urgent to be transcribed so that Emma Daunton, our oncologist, can read them today. We'll give you a check-up here after the radiotherapy has concluded, and give you instructions on how you can get hold of me during office hours if you have questions. I believe Sherlock has my email address and my personal phone number if there is an urgent matter."

They spend some more time going through the tablet-form hormonal treatment George needs to take before the radiotherapy, and Hallard writes him a prescription for it. Sherlock asks questions, tries to make sure everything is clarified in a language a layperson would understand. He often fails at explaining things to his patients and relies on Marie to gauge those needs.

His father is mostly quiet but attentive, possibly overwhelmed by the barrage of information.

"I assume Mum can go with you to see the oncologist?" Sherlock asks him. "I'm afraid I have to go back to King's; I'm the chairman of the M&M meeting today."

"Yes, yes, of course she can," George confirms.

As Sherlock had guessed, no thief has been keen on George's old coat, which they collect from the hallway after giving their thanks to Mister Hallard.

"Where have you parked Violet, then?" George asks.

"Cafe in the entrance hall. She may be a bit huffy."

"Nothing I've not seen before."

"Dad, about the… accommodations," Sherlock starts. Hallard had mentioned that radiotherapy can get tiring and have short-term side effects which means that George might want to consider booking a spot at the Chelsea & Westminster Patient Hotel, offering more medical services than the average regular London hotel would.

"Yes?"

"You should, I mean you _could_ stay with me and John. Mycroft's the other option, but he's mostly in Zurich, so his place would be empty."

"And he's not a doctor," George points out. "I appreciate the offer; I would like it very much if I could stay with you and John."

The length of the radiotherapy varies between one and eight weeks. Hallard had said that most likely they'll be looking at two or three. The modern IMRT method—meaning Intensity Modulated RadioTherapy—can spare healthy around the prostate tissue well while still guaranteeing a good focus on the target organ.

"Our place on Baker Street is smaller than our place in Brompton, but there is a guest bedroom upstairs if I clear out some of my research papers. Or, you can take the one downstairs and John and I can move upstairs for a few weeks. Or, we can––"

George interrupts his train of thought with a hand on his shoulder, which makes him flinch slightly, but it stays there. "Sherlock. You have done well. Not just with today, but… I will make sure Violet knows that."

" _I_ know that," Sherlock says pointedly. That epiphany is no thanks to his parents, but he isn't going to blame George for anything but withdrawing to the side lines. "I'm not sure it will ever sink in with her."

George's hand leaves his shoulder. "I know things have not been good between you and her after Christmas."

"What happened was a long time coming."

"She loves you very much."

"And has a funny way of showing it."

"She isn't perfect. Nobody is."

"She thinks Mycroft is and I certainly am not, and it appears to be the great tragedy of her life."

"There are things she didn't dare to hope for you, and has a hard time believing are real."

Sherlock looks at his shoes, rubs his wrist with his other hand. "I won't let it be my problem anymore."

"She is still your mother. I very much hope that you would talk to her. Come visit. She's been devastated after Christmas."

"Because of all the things she thinks I've slighted against her."

"No, because you won't talk to her. It was such a great help when you got us this appointment, especially for her."

"I did it for you, not Mummy."

"Of course. She feels responsible for this family, for looking after everyone. That's what she has always done. But, she didn't quite know what to do this time."

"But, instead of asking for proper help she saw fit to underestimate everyone else's ability to be useful. Except John's," Sherlock scoffs. "John, her golden son-in-law. Her _replacement_."

He isn't as angry as the content of his words might signal. Talking to Doctor Pichler has helped immensely in shedding some of the rage he has always felt but never expressed. Now, he's expressing it, and it's been like shedding pieces of it away every time he makes someone else acknowledge the way he has felt for a long time.

He expects his father to protest his harsh words, to tell him he's exaggerating and being childish. But, George has lived with Violet for forty years. He knows what she is like. Even if he is complicit in the things about which Sherlock is bitter and angry he has, in his passive and quiet way, been supportive of him. When he was a teen and things blew up with Mummy on a regular basis, it was often his dad who reached out, took him out for ice cream or a walk, or just came to talk to him—to listen to him rant. He took Sherlock seriously, and there's something to be said for that.

"The first time you visited with John and we watched you drive off… Do you know what your mother said to me?"

"There's no way for me to know that," Sherlock protests before realising it had probably been a rhetorical question.

"She said: ' _that's a very lucky man'_."

Anger floods in. "Of course she would have said that; she thinks John is a saint for––"

George raises his hand to silence him. "She said: _'that's a very lucky man, because he could not have done better than our William_ '. Yesterday, she called our neighbour to tell her we had this appointment, and that her son had arranged it all. _'No, the other one_ ,' she corrected when they assumed she was speaking of Mikey; _'The one who is a famous London surgeon!_ ' I know it's hard for her to see anything but the two of you as kids, but people's opinions can change, Sherlock. Even hers, but it won't happen if you completely turn away from her. If you won't talk to her."

"Christmas was horrible. I might go to South Africa with John next December. My trainee will be working there by then; there's excellent diving, and I could take John on a safari."

"Oh." George doesn't completely manage to conceal his disappointment. "I'm sure it will be lovely. But Sherlock, please come visit soon."

Sherlock swallows. "We'll see. Maybe."

"Promise? That you'll come see us this Spring?"

"Alright," he relents. Making such a promise to him feels much easier to giving in to Mummy's whims. It's always been her who books all the asinine family reunions.

"Give my love to John. I will let you know about the radiotherapy schedules."

"Yes," Sherlock replies curtly. "Take care," he offers, imagining it is something John or Marie might say at this point.

"You too, son."

 

**— The End —**

**Notes for the Chapter:**

> How will George manage his radiotherapy? What sorts of professional challenges will Sherlock face next? Can there ever be even the slightest reconciliation between him and Violet? 
> 
> You shall find out in _**You Go To My Head: Wide Awake**_ , which will be published towards the middle of the year. 
> 
> Meanwhile, I have been a busy bee drafting a future part of _You Go To My Head_ with [7PercentSolution](https://archiveofourown.org/users/7PercentSolution/pseuds/7PercentSolution), as well as joining forces with [elldotsee](https://archiveofourown.org/users/elldotsee/pseuds/elldotsee) for very exciting AU project:
> 
>  
> 
>  
> 
> No precise publication date exists yet, but it will be sooner rather than later. We are making good progress on this.
> 
>  ** _Summary:_** _Invalided home from Afghanistan, running out of funds and convinced that his surgical career is over, John Watson accepts a mysterious job offer to provide care and companionship for a disabled person. Little does he know how much hangs in the balance of his performance as he settles into his new life at Musgrave Court._


End file.
